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Kaiser Permanente Survey Shows Seniors Embrace Internet To Manage Their Health
New data show that Medicare beneficiaries registered to use My Health Manager, Kaiser Permanente"s personal health record, are overwhelmingly satisfied with using the Internet to manage their health care online. Results from the recent Kaiser Permanente survey examining Web site usage and Medicare beneficiary satisfaction were presented today at the World Health Care Congress" 5th Annual Leadership Summit on Medicare in Washington, D.C.
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New Center Of Excellence Targets Reducing Disparities In Cancer Care And Outcomes
The University of South Florida and Moffitt Cancer Center have been awarded a highly competitive, $6-million federal grant to create a National Center on Minority Health and Health Disparities (NCMHD) Center of Excellence. The five-year program grant from the NCMHD, National Institutes of Health, will focus on research, education and training, and community outreach activities to reduce cancer-related health disparities among minority and underserved communities in Florida.
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Columnists Respond To Selection Of Sotomayor As Supreme Court Nominee
The New York Times, Washington Post and Washington Times recently published opinion pieces on President Obama"s nomination of Judge Sonia Sotomayor to the Supreme Court. Summaries appear below.~ David Brooks, New York Times: "Supreme Court justices, like all of us, are emotional intuitionists" because "they begin their decision-making processes with certain models in their heads," Times columnist Brooks writes, adding that "[t]hese are models of how the world works and should work, which have been idiosyncratically ingrained by genes, culture, education, parents and events," and which "shape the way judges perceive the world." Therefore, the "crucial question in evaluating a potential Supreme Court justice ... is not whether she relies on empathy or emotion, but how she does so," according to Brooks. He writes that Sotomayor "will be a good justice if she can empathize with the many types of people and actions involved in a case, but a bad justice if she can only empathize with one type, one ethnic group or one social class." He concludes, "It"s not whether judges rely on emotion and empathy, it"s how they educate their sentiments within the discipline of manners and morals, tradition and practice" (Brooks, New York Times, 5/29).~ Michael Gerson, Washington Post: By opposing Sotomayor"s confirmation, Republicans could be entering "a trap" by "further alienating Hispanic voters the GOP has recently driven away in droves," which might "confirm an image of Republicans as the party of the male and pale," columnist Gerson writes in a Post opinion piece. He continues, "Barring unforeseen ethical revelations, opposition to Sotomayor seems both politically risky and ultimately futile." However, "Republicans must still enter the trap -- with open eyes and no expectation of gain -- not to defeat a nominee but to maintain a principle" that the court "should be a place where all are judged impartially, as individuals," Gerson writes. He continues that the "Obama/Sotomayor doctrine of empathy challenges this long-established belief," and this "is not a minor matter." According to Gerson, "Concerns about the doctrine of empathy will not defeat Sotomayor -- and perhaps they should not defeat her." However, the "problems raised by selective empathy require a substantive (not harsh or personal) national debate -- and this requires Republicans to carefully, warily, enter Obama"s trap" (Gerson, Washington Post, 5/29).~ Michael Kinsley, Washington Post: "What conservative Republicans don"t like about the Supreme Court can be summarized as three, or maybe four, A"s: abortion, affirmative action and activism," columnist Kinsley writes in a Post opinion piece. He adds that "[r]ecent Republican platforms have pledged to appoint judges who not only will overturn Roe [v. Wade] but will make clear that fetuses have the same rights as people under the 14th Amendment"s guarantee of "equal protection of the laws."" Kinsley continues that supporters of Roe "clearly represent the "activist" side," while opponents of the decision "are right that Roe represents the highest tide of Warren Court activism." However, this "doesn"t mean the critics of Roe are right on the merits;" rather, it means that ""activism" is a near-worthless concept, and comparative activism is nonsense," Kinsley writes. He continues, "Although I am pro-choice, Roe makes me unhappy because it was poorly reasoned, not because it "went further" than other decisions." According to Kinsley, "many opponents of Roe would not be satisfied with merely seeing it overturned and the issue returned to the states," and, in fact, the GOP platform "effectively calls for a litmus test for judges: Will they rule abortion illegal in all 50 states no matter what the people want?" He continues, "Now that would be judicial activism with a vengeance" (Kinsley, Washington Post, 5/29).~ Eugene Robinson, Washington Post: The fact that Sotomayor "is a proud and accomplished Latina" apparently "drives some prominent Republicans into a s
Oncology

Study Redefines Roles Of Alcohol, Smoking In Risk For Pancreatitis

Although alcohol consumption is known to be associated with chronic pancreatitis, new evidence indicates that a threshold of five or more drinks per day is required to significantly raise risk; however, most patients with chronic pancreatitis do not drink this amount, according to a report in the June 8 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In addition, smoking is an independent, dose-dependent risk factor. "Chronic pancreatitis is an inflammatory syndrome of the pancreas characterized by progressive parenchymal fibrosis [scarring of the organ], maldigestion, diabetes mellitus and pain," the authors write as background information in the article. "Recurrent acute pancreatitis [acute pancreatitis that occurs on two or more occasions and may become chronic] and chronic pancreatitis are associated with alcohol consumption and cigarette smoking. The etiology of recurrent acute pancreatitis and chronic pancreatitis is complex, and effects of alcohol and smoking may be limited to specific patient subsets." Dhiraj Yadav, M.D., M.P.H., of the University of Pittsburgh, and colleagues in the North American Pancreatic Study Group examined the current prevalence of alcohol use and smoking and their association with pancreatitis in patients evaluated at U.S. referral centers. Between 2000 and 2006, 1,000 patients (540 with chronic pancreatitis and 460 with recurrent acute pancreatitis) were enrolled in the North American Pancreatitis Study 2 (NAPS2), as were 695 healthy controls. All participants (average age 49.7) reported their alcohol consumption and smoking habits. About one-fourth of both controls and patients were lifetime abstainers. Among those with chronic pancreatitis, 38.4 percent of men and 11 percent of women were very heavy drinkers (five or more drinks per day), compared with 16.9 percent of men and 5.5 percent of women with recurrent acute pancreatitis and 10 percent of men and 3.6 percent of women in the control group. "We found the threshold drinking amount for association between alcohol use and chronic pancreatitis to be five or more drinks per day," the authors write. Compared with abstaining and light drinking (half a drink per day or less), very heavy drinking was associated with approximately triple the odds of developing chronic pancreatitis. However, fewer patients with chronic pancreatitis than expected (about one-fourth) drank at this level. Other factors, including genetic mutations, also contribute to pancreatitis risk. Although many heavy drinkers also smoked, cigarette use was an independent risk factor for both chronic pancreatitis and recurrent acute pancreatitis. Among smokers, those with chronic pancreatitis tended to smoke more (26.6 pack-years, vs. 19.5 pack-years for those with recurrent acute pancreatitis and 16.2 pack-years for controls; one pack-year is about 7,300 cigarettes smoked) and had smoked for a longer period of time (a median or midpoint of 30.5 years, vs. 21.9 years for controls and 22.7 years for those with recurrent acute pancreatitis), suggesting a dose-dependent effect. "In conclusion, only very heavy alcohol consumption and cigarette smoking are independent risk factors for chronic pancreatitis," the authors write. "Risk for chronic pancreatitis from alcohol consumption occurs above a threshold level, while risk due to smoking is dose dependent. Drinking levels in subjects with recurrent acute pancreatitis are similar to controls. Only a minority of patients with recurrent acute pancreatitis and chronic pancreatitis currently seen at secondary or tertiary U.S. centers could be categorized as very heavy drinkers." Arch Intern Med. 2009;169[11]:1035-1045. Archives of Internal Medicine


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